HSJ Article – Tackling the Four-Hour A&E Target

Published: 26th July 2018

Tackling the Four-Hour A&E Target with a whole system approach A feature created by HSJ in co-operation with Luton & Dunstable University Hospital Written by Claire Read, HSJ Reliably meeting the four hour A&E target – under which 95 per cent of patients should be treated, assessed or discharged within four hours of their arrival […]

Tackling the Four-Hour A&E Target with a whole system approachA feature created by HSJ in co-operation with Luton & Dunstable University Hospital

Written by Claire Read, HSJ

Reliably meeting the four hour A&E target – under which 95 per cent of patients should be treated, assessed or discharged within four hours of their arrival in the department – is now a year-round worry for many healthcare leaders.

For staff in some emergency departments, it is a goal which has come to be seen as impossible and a source of near-constant demoralisation. After all, England as a whole last hit the target in July 2015.

But at Luton and Dunstable University Hospital Foundation Trust, it is a goal which is not only consistently met: it’s consistently exceeded. In May 2018, the care of 98.4 percent of patients arriving at the A&E department was completed within four hours. It was pretty much the same in May 2017. And the year before that.

So how have they done it? What are the ingredients for their success? And what aspects might others be able to emulate?

Those working in the local clinical commissioning group (CCG) and community provider point to the value of a whole system approach, with as much emphasis on what happens at the back door of the hospital as at the front, and the need for strong communication.